Individual
MADISON MARIE MASTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
106 S LAFAYETTE ST, SOUTH LYON, MI 48178-1404
(947) 348-1176
Mailing address
4235 SECOR RD, TOLEDO, OH 43623-4299
(419) 473-3561
(419) 479-5593
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0464392
—
OH
Enumeration date
06/08/2021
Last updated
06/02/2025
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